DESCRIPTION: The primary goal of this revised RO1 application is to determine the health and socioeconomic consequences of nonspecific building-related illness (NSBRI) (or sick building syndome) in workers diagnosed with this prevalent disorder. More than half of the U.S. workforce is now employed in indoor nonindustrial environments. Various symptoms and illnesses have increasingly been reported in such nonindustrial indoor environments. NSBRI refers to a common nonspecific disorder which is usually associated with a particular building. Although objective physiologic abnormalities are generally not noted, NSBRI can be extremely unpleasant and an important cause of disability and lost work time. Despite this, NSBRI has received scant scientific attention from a clinical and economic perspective. Little progress has been made in establishing: 1) diagnostic criteria, 2) the natural history or clinical course of NSBRI, 3) the social and economic consequences of this common and important occupational health problem, or 4) the predictors of adverse outcomes. Our Specific Aims are: Aim 1 A) Identify and classify NSBRI cases using several different case definitions of NSBRI. Aim 1 B) Determine associations between the different case definitions and the various outcome variables. Aim 2 A) Characterize the natural history of NSBRI following diagnosis. Aim 2 B) Determine which host factors (i.e. age, marital status, initial symptoms) and workplace factors (i.e. job stress, work environment) are associated with disease progression and severity. Aim 3 A) Determine the effect of NSBRI on socioeconomic outcomes (i.e. work-disability, employment status, financial status). Aim 3 B) Determine which host factors and workplace factors are associated with more adverse socioeconomic outcomes. The overall study design will be a retrospective longitudinal follow-up study of 75 patients diagnosed with NSBRI at the YOEMP Clinic from 1994 to 1999. A similar group of 75 musculoskeletal patients matched on age, gender and year of diagnosis will be used as scontrols for the socioeconomic analysis. Phone interviews will assess symptoms, general health, functional status, disability, stress, and socioeconomic status since diagnosis of NSBRI. This study should identify diagnostic criteria, increase our understanding of the natural history and socioeconomic consequences of NSBRI, as well as identify risk factors associated with worse outcomes. This information is critical for the development of interventions to prevent and/or ameliorate the adverse consequences of NSBRI.